HomeMy WebLinkAboutFilled Land AffidavitPLANNING & DEVELOPMENT SERVICES DEPARTMENT
• Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
(Parcel Id#/Legal d ription/Address) oa 6
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number
acknowl
that as owner of the above described property, and in accordance 1. with Sectdion
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
U),
Property Owner Name (Please Print)
Property ignature
sSTATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED EIEFORE ME THIS
BY
PRODUCED
S NATURE OF N rAR UBLIC
GGOg4gat COMMISSION NUMBER
SLCPDSD Revised 04/11/2011
DAY OF 20 /i 1
IS PERSONALLY KNOWN T E C OR WHO HAS
AS IDENTIFICATION
ZIC.�'AkC QltiiyC)�NjOH
TYPE OR PRINT YIQ
(SEAL)
.............
RICHARD DOUGLAS JOHNSON
Nmary Public - Side of FloriCa
Comm ssior. k GG 084821
My Comm. Empires Mar 20.2021
Banded 1hrayhNabonalNolaryAsn.